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目的探讨妊娠糖尿病(GDM)哺乳期妇女初乳、42天和90天成熟乳中真胰岛素水平,分析其相关因素及其对婴儿体格发育的影响。方法采用双位点单克隆抗体夹心放大酶联免疫分析法(BA-ELISA)测定GDM产妇和健康产妇初乳、42天和90天成熟乳及新生儿脐血中真胰岛素水平,监测婴儿90天内生长情况。结果 GDM组初乳及90天成熟乳中真胰岛素水平均高于对照组(22.8μU/ml比20.4μU/ml,33.6μU/ml比23.5μU/ml,P均<0.05)。母亲孕前、产前、产后42天和90天的体质指数(BMI)与90天成熟乳中真胰岛素水平正相关,产后42天BMI与42天成熟乳中真胰岛素水平正相关,孕期糖化血红蛋白百分比与90天成熟乳中真胰岛素水平正相关,剖宫产者初乳真胰岛素水平低于阴道分娩者(21.2μU/ml比96.3μU/ml,P<0.05)。42天时高母乳喂养组母乳中真胰岛素水平低于低母乳喂养组(29.7μU/ml比69.6μU/ml,P<0.05)。脐血中真胰岛素水平与出生体重和身长正相关,42天成熟乳中真胰岛素水平与出生至42天的体重增长值负相关,90天成熟乳中真胰岛素水平与90天头围负相关。结论 GDM哺乳期妇女母乳中真胰岛素水平较正常哺乳期妇女高,分娩方式和喂养方式对成熟乳中真胰岛素水平有影响,母乳中真胰岛素水平与孕产妇的BMl值呈正相关,对婴儿体格生长起调节作用。
Objective To investigate the level of true insulin in the milk of women with gestational diabetes mellitus (GDM) during lactation, mature milk at days 42 and 90, and analyze the related factors and their effects on the physical development of infants. Methods Double-site monoclonal antibody sandwich amplification enzyme-linked immunosorbent assay (BA-ELISA) was used to determine the levels of true insulin in GDM maternal and healthy maternal colostrum, mature milk and neonatal cord blood at 42 days and 90 days. growing situation. Results The levels of true insulin in colostrum of GDM group and mature milk of 90 days were higher than that of control group (22.8μU / ml vs 20.4μU / ml, 33.6μU / ml vs 23.5μU / ml, P <0.05). Mother’s pre-pregnancy, prenatal, postpartum 42 days and 90 days body mass index (BMI) and true milk 90 days mature insulin levels, 42 days postpartum BMI and real milk 42 days mature insulin levels, pregnancy glycosylated hemoglobin percentage True level of true insulin in 90-day mature milk was positively correlated with true insulin levels in the cesarean colostrum than in vaginal delivery (21.2 μU / ml vs 96.3 μU / ml, P <0.05). True-insulin levels were lower in the high-breast-fed group at 42 days than in the low-breast-fed group (29.7 μU / ml vs. 69.6 μU / ml, P <0.05). Genuine insulin levels in cord blood correlated positively with birth weight and body length, while true insulin levels in 42-day mature milk were negatively correlated with body weight gain from birth to 42 days, while true insulin levels in 90-day mature milk were negatively correlated with 90 days. Conclusion The true insulin level in breast milk of lactating women with GDM is higher than that of normal breast-feeding women. The modes of delivery and feeding mode affect the level of true insulin in mature milk. The true insulin level in breast milk is positively correlated with BMl of pregnant women, Play a regulatory role.